Gemcitabine and cisplatin induction chemotherapy followed by concurrent chemoradiotherapy for stage III-IVA nasopharyngeal carcinoma: A real-world study.

Abstract

Introduction: This study aims to evaluate the efficacy of combining induction chemotherapy with concurrent chemoradiotherapy for patients with stage III-IVA nasopharyngeal carcinoma (NPC), particularly focusing on cases associated with Epstein-Barr virus infection. The primary focus is on treatment response and disease control.

Methods: This retrospective cohort study analyzed data from 81 patients with stage III-IVA NPC (excluding T3N0M0) treated with gemcitabine and cisplatin as induction chemotherapy, followed by concurrent chemoradiotherapy at the Vietnam National Cancer Hospital. Patient data and follow-up information were collected between June 2021 and June 2024, focusing on disease-free survival (DFS) as the primary outcome and secondary outcomes including factors affecting DFS and treatment-related toxicity.

Results: In the initial 3-month period, 76 out of 81 patients achieved a complete response, and five patients achieved a partial response. The follow-up period averaged 18.7 ± 5.3 months, with a 2-year DFS rate of 77.6%. Key factors influencing DFS included patient age, N stage, disease stage, and treatment interruptions. Grade 3 toxicities observed included neutropenia (17.3%) and mucositis (32.1%), while grade 4 toxicity was limited to nausea (2.4%). Additionally, 2.6% of patients experienced delayed grade I-II toxicities, with some presenting grade III anorexia.

Conclusion: Our findings suggest that gemcitabine and cisplatin induction chemotherapy, followed by chemoradiotherapy, may result in a high response rate and effective disease control with manageable toxicity. However, further research is needed to evaluate long-term outcomes and potential delayed adverse effects to confirm these initial observations.